The present invention relates generally to treatment of severe obesity in humans, and more particularly to an improved surgical procedure, and apparatus used in such procedure, for treating severe obesity that is not readily controlled by diet, medication, or behavior modification techniques.
Extreme obesity is a major disease both in the United States and other countries. Its complications include hypertension, diabetes, coronary artery disease, stroke, congestive heart failure, venous disease, orthopedic problems and pulmonary insufficiency. Attempts to reduce extreme obesity by dietary, and/or behavior modification techniques hve been generally quite unsucessful. Diets simply do not work. Drug therapy and psychotherapy are effective only as long as the patient is under intensive treatment; any loss of weight is usually quickly regained after the patient discontinues the treatment. In general, non-surgical techniques have had a long-term success rate of less than 2%. Heretofore, several surgical techniques have been developed aimed at a reduction of absorption of nutrients from ingested food. Of these, the procedure that has been performed on the greatest number of patients as a surgical attempt to control morbid obesity is the jejunoileal bypass. The disadvantage of the jejunoileal bypass is its long-term consequences. An unacceptably large fraction of bypass patients experience severe and debilitating complications such as progressive liver failure, electrolyte imbalance, renal disease and/or bowel disorders.
In Contemporary Surgery, volume 23, December 1983, Griffen et al. describe several surgical procedures that avoid the metabolic distrubances commonly associated with the jejunoileal bypass. These surgical techniques generally involve stapling together the two walls of the stomach to provide a reduced-volume proximal pouch for receiving ingested food. These stapling techniques necessarily involve multiple perforations of the stomach wall with a substantial risk of leakage, tearing and infection. Moreover, the cross-sectional area of the thru-flow aperture, left open after the stapling operation, cannot be predetermined or controlled with any reasonable accuracy. Depending on the metabolism of the particular patient, the resulting absorption of nutrients may be far off the mark. In addition, rows of metallic staples are difficult to remove; these stapling operations cannot be reversed without extreme risk to the patient.
In short, none of the surgical procedures used heretofore have been completely satisfactory. A need exists for an improved method and apparatus for gastroplastic treatment of morbid obesity.
Accordingly, it is an object of my invention to enable gastric partitioning with reduced risk of post-operative leakage and/or infection while providing for post-surgical adjustment of the flow to distal portions of the gastrointestinal tract, thereby enhancing post-operative control of obesity.
It is a further object of my invention to enable gastroplasty with no invasion of the gastrointestinal tract while providing for adjustment, from time to time, of the rate of permitted flow from the proximal portion of the stomach to distal portions of the gastrointestinal system.
It is a still further object of my invention to provide a gastroplasty method and apparatus that features postoperative adjustment of the flow of nutrients to the intestinal tract while enabling rapid and facile installation with reduced risk of gastric leakage and infection.